Azpiroz F, Dubray C, Bernalier-Donadille A, Cardot J-M, Accarino A, Serra J, Wagner A, Respondek F, Dapoigny M
Digestive System Research Unit, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain.
Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain.
Neurogastroenterol Motil. 2017 Feb;29(2). doi: 10.1111/nmo.12911. Epub 2016 Jul 31.
Short-chain fructooligosaccharides (scFOS) have beneficial effects in subjects with minor digestive complaints, but the potential mechanisms involved have not been elucidated. The aim of the study was to evaluate changes in rectal sensitivity related to the clinical effects of scFOS in a selected group of patients with irritable bowel syndrome (IBS) and rectal hypersensitivity.
In 79 IBS patients (defined by Rome III criteria) with rectal hypersensitivity (defined as discomfort threshold ≤44 g) a parallel, placebo-controlled, randomized, and double-blind study was performed to assess the effects of dietary supplementation (5 g d ) with scFOS vs placebo for 4 weeks on rectal sensitivity (primary outcome: tolerance to increasing wall tension applied by a tensostat), clinical outcomes (IBS, anxiety/depression and quality of life scores) and composition of fecal microbiota.
Rectal discomfort threshold, and IBS and quality of life scores, significantly improved during treatment, but in a similar manner in both scFOS and placebo groups; a post-hoc analysis showed that the effect of scFOS on rectal sensitivity was more pronounced in constipation-predominant-IBS patients (P=.051 vs placebo). Contrary with placebo, scFOS significantly reduced anxiety scores and increased fecal Bifidobacteria (P<.05 for both) without modifying other bacterial groups.
CONCLUSIONS & INTERFENCES: The effect of scFOS on anxiety may be related to modulation of the gut microbiota; demonstration of effects of scFOS on rectal sensitivity may require higher doses and may depend on the IBS subgroup.
短链低聚果糖（scFOS）对有轻微消化问题的受试者有益，但其中涉及的潜在机制尚未阐明。本研究的目的是评估在一组患有肠易激综合征（IBS）和直肠高敏的患者中，与scFOS临床效果相关的直肠敏感性变化。
对79例符合罗马III标准且有直肠高敏（定义为不适阈值≤44克）的IBS患者进行了一项平行、安慰剂对照、随机双盲研究，以评估补充饮食（5克/天）scFOS与安慰剂4周对直肠敏感性（主要结局：对张力计施加的逐渐增加的肠壁张力的耐受性）、临床结局（IBS、焦虑/抑郁和生活质量评分）以及粪便微生物群组成的影响。
治疗期间直肠不适阈值、IBS和生活质量评分均显著改善，但scFOS组和安慰剂组的改善方式相似；事后分析表明，scFOS对直肠敏感性的影响在以便秘为主的IBS患者中更为明显（与安慰剂相比，P = 0.051）。与安慰剂相反，scFOS显著降低焦虑评分并增加粪便双歧杆菌（两者P均<0.05），而不改变其他细菌组。
scFOS对焦虑的影响可能与肠道微生物群的调节有关；scFOS对直肠敏感性影响的证明可能需要更高剂量，并且可能取决于IBS亚组。
